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Light Chain Amyloidosis: Patient Experience Survey from the Amyloidosis Research Consortium.

IntroductionInformation detailing the experience of patients with light chain (AL) amyloidosis is lacking. The primary aim of this study was to gather data on the patient experience to understand the challenges in diagnosis and to gain insight into barriers to accessing appropriate care.MethodsPatients with amyloidosis, family members, and caregivers were invited to participate in an online 16-question survey (available from January 29 to February 5, 2015). Participants with AL amyloidosis were sent an eight-question follow-up survey.ResultsThe initial survey was completed by 533 participants

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… | 75 (18.7) Gastroenterologist | 32 (8.0) Neurologist | 19 (4.7) Primary care physician | 16 (4.0) Other a | 32 (8.0) Fig. 1 Types of physicians visited before diagnosis of amyloidosis Respondents saw cardiologists more frequently than hematologists/oncologists and nephrologists, though cardiologists … Nephrologists and cardiologists provided the correct diagnosis for 22.6% and 18.7% of respondents, respectively (Table 2 ). …

Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low-birth-weight infants.

BACKGROUND: In preterm newborns, the ductus arteriosus frequently fails to close and the infants require medical or surgical closure of the patent ductus arteriosus (PDA). A PDA can be treated surgically or medically with one of two prostaglandin inhibitors, indomethacin or ibuprofen. Case reports suggest that paracetamol may be an alternative for the closure of a PDA. Concerns have been raised that in neonatal mice paracetamol may cause adverse effects on the developing brain, and an association between prenatal exposure to paracetamol and later development of autism or autism spectrum disord

[Patients after acute decompensation of Heart Failure: adherence to self-monitoring and treatment depending on the mode of outpatient monitoring].

Aim      To evaluate compliance with self-monitoring and drug and non-drug treatment of patients after ADHF during the management at a specialized center for CHF treatment (CCHF) or in real-life clinical practice.Material and methods  The study included 942 CHF patients after ADHF. In two years, the entire sample of patients was retrospectively divided into 4 groups based on their compliance with the management at the CCHF: group 1, 313 patients who were managed at the CCHF continuously for two years; group 2, 383 patients who choose the management at district outpatient clinics after discharg

Recombinant human growth hormone treatment for dilated cardiomyopathy in children.

OBJECTIVE: Dilated cardiomyopathy (DCM) is one of the most common causes of heart failure among children and is often progressive despite maximal medical therapy. Heart failure is characterized by a number of neurohormonal abnormalities, including derangements in the growth hormone (GH)/insulin-like growth factor-1 (IGF-1) signaling axis. Decreased serum levels of GH, which acts on cardiac myocytes primarily through IGF-1, are associated with impaired myocardial growth and function, which can be improved with restoration of GH/IGF-1 homeostasis. In animal models and among human adults with hea

Emergency percutaneous coronary intervention (PCI) for the care of patients with ST-elevation myocardial infarction (STEMI).

There is general consensus that emergency percutaneous coronary intervention (PCI) is the preferred treatment for patients with ST-elevation myocardial infarction (STEMI), so long as it can be delivered in a timely fashion, by an experienced' operator and cardiac catheterization laboratory (CCL) team. STEMI is both a functional and structural issue. Although it has been recognized since the work of pioneering cardiologists and surgeons in Spokane, Washington, that approximately 88% of patients presenting within 6 hours of onset of STEMI have an occluded coronary artery, it is the pathophysiolo…

Molecular sources of residual cardiovascular risk, clinical signals, and innovative solutions: relationship with subclinical disease, undertreatment, and poor adherence: implications of new evidence upon optimizing cardiovascular patient outcomes.

Residual risk, the ongoing appreciable risk of major cardiovascular events (MCVE) in statin-treated patients who have achieved evidence-based lipid goals, remains a concern among cardiologists. Factors that contribute to this continuing risk are atherogenic non-low-density lipoprotein (LDL) particles and atherogenic processes unrelated to LDL cholesterol, including other risk factors, the inherent properties of statin drugs, and patient characteristics, ie, genetics and behaviors. In addition, providers, health care systems, the community, public policies, and the environment play a role. Majo…

Рамки качества " Эхокардиографии " : всеобъемлющий подход к обеспечению качества и непрерывному совершенствованию услуг с учетом интересов пациентов.

Система качества " Echocardicography Framework " (EQF) представляет собой уникальный, всеобъемлющий, целостный подход к совершенствованию всех аспектов службы эхокардиографии. EQF представляет собой ориентированную на пациентов программу, объединяющую обеспечение качества и непрерывное совершенствование обслуживания. Эта рамочная основа охватывает следующие показатели: i) качество эхокардографии, ii) воспроизводимость и последовательность, iii) образование и профессиональная подготовка и iv) обратная связь с клиентами. EQF масштабируется и адаптируется для использования любой эхокард

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… Regular ‘group review’ of studies selected at random, marked by the group, facilitated by a senior echocardiographer (cardiologist or physiologist) with recorded outcomes. Domain 1B. Echocardiogram report Do our reports help clinicians provide better patient care? … Since patients are referred for echocardiography by a wide variety of clinicians – physicians, anesthetists, GP’s, nurses, cardiologists and others – it is important to provide a report that is comprehensible and relevant to these referrers. …

Сердечные эффекты и коморбиды неврологических заболеваний.

Неврологические расстройства охватывают сложный и неоднородный спектр заболеваний, затрагивающих мозг, спинной мозг и периферийные нервные системы, каждая из которых сопряжена с уникальными проблемами, выходящими далеко за рамки первичных неврологических симптомов. Эти расстройства оказывают глубокое воздействие на сердечно-сосудистое здоровье, что приводит к интенсивному изучению сложных взаимосвязей между неврологическими и сердечно-сосудистыми системами. В этом обзоре обобщаются текущие сведения и исследования о сердечно-сосудистых коморбидах, связанных с основными неврологическими заболева

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… Furthermore, fostering a multidisciplinary approach involving neurologists, cardiologists, and other allied healthcare professionals is crucial. … Incorporating these pharmacological interventions into the treatment regimen of neurological patients requires close collaboration between neurologists, cardiologists, and other healthcare professionals. …

Diagnostic Trends and Geographic Health Care Disparities Among Patients With Transthyretin Amyloid Cardiomyopathy.

BACKGROUND: Transthyretin amyloid cardiomyopathy (ATTR-CM) is a rare, life-threatening form of restrictive cardiomyopathy. Access to cardiology providers and specialized amyloid centers may impact ATTR-CM diagnosis. We sought to elucidate diagnostic disparities of ATTR-CM through assessment of diagnostic trends and the geographic distribution of amyloid centers and cardiology providers in the United States. METHODS: This was a cross-sectional geospatial analysis of amyloid centers and cardiology providers and a retrospective cohort analysis of patients with ATTR-CM from the Komodo Healthcare

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… County‐level estimates of cardiologists in the United States using data from HealthLink Dimensions demonstrated that 46.3% of counties had no cardiologists, and 86.2% of rural counties had no cardiologists. 8 The average round‐trip distance to the nearest cardiologist was 16.3 miles in counties with … cardiologists, but was 87.1 miles in counties without cardiologists. 8 Counties without cardiologists had higher age‐adjusted cardiovascular mortality rates compared with counties that had cardiologists. 8 In the current study, mean distance to an amyloid center was 48.5 miles, resulting in an average …

The Multidisciplinary Heart Team in Cardiovascular Medicine: Current Role and Future Challenges.

Cardiovascular multidisciplinary heart teams (MDHTs) have evolved significantly over the past decade. These teams play a central role in the treatment of a wide array of cardiovascular diseases affecting interventional cardiology, cardiac surgery, interventional imaging, advanced heart failure, adult congenital heart disease, cardio-oncology, and cardio-obstetrics. To meet the specific needs of both patients and heart programs, the composition and function of cardiovascular MDHTs have had to adapt and evolve. Although lessons have been learned from multidisciplinary cancer care, best practices

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… The core members of the MDHT for advanced HF patients typically include advanced HF cardiologists, APCs, pharmacists, nurses, and HF program coordinators. … Evaluation from a cardiac surgeon and/or an interventional cardiologist on the MDHT is warranted in patients with severe VHD to determine which, if any, intervention is indicated preemptively to avoid decompensation during pregnancy. …

A comparative content and quality analysis of patent ductus arteriosus-related health information on Bilibili and TikTok.

BACKGROUND: The rapid expansion of short-form educational video platforms has substantially increased public access to health information; however, the characteristics and quality of videos concerning patent ductus arteriosus (PDA) have not been systematically evaluated. This study aimed to evaluate the quality and reliability of short-form videos related to PDA posted on TikTok and Bilibili. METHODS: The Chinese keyword "patent ductus arteriosus" was used to retrieve relevant videos from TikTok and Bilibili, yielding 140 videos for the final analysis. Uploaders were classified according to p

[Perioperative myocardial infarction and cardiac complications after noncardiac surgery in patients with prior myocardial infarction. I. Clinical data and diagnosis, incidence].

UNLABELLED: Patients with a prior myocardial infarction (MI) have a high risk of perioperative reinfarction compared with the normal population (5%-8% vs. 0.1%-0.7%) [10]. According to Rao [13], a reduction of this risk is possible when patients are monitored invasively and all haemodynamic parameters are kept within the physiological range. In most institutions it is not feasible to treat patients as Rao recommended: this would overstrain both hospital structure and financial resources. We studied the incidence of perioperative MI and other cardiac events in patients with prior MI. During the

Healthcare disparities in cardio oncology: patients receive same level of surveillance regardless of race at a safety net hospital.

BackgroundCardiotoxicity remains a dreaded complication for patients undergoing chemotherapy with human epidermal growth factor (HER)-2 receptor antagonists and anthracyclines. Though many studies have looked at racial disparities in heart failure patients, minimal data is present for the cardio-oncology population.MethodsWe queried the echocardiogram database at a safety net hospital, defined by a high proportion of patients with Medicaid or no insurance, for patients who received HER2 receptor antagonists and/or anthracyclines from January 2016 to December 2018. Patient demographics, clinica

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… Due to lack of established referral guidelines, the decision for oncologists to refer patients to cardiologists can be varied. … The nuances of chemotherapy and cardiotoxicity can be a complex process; while oncologists are not well versed in cardiovascular complications, general cardiologists may not be familiar with the specific nuances of each chemotherapy agent. …

Brazilian consensus recommendations on the diagnosis and treatment of light chain amyloidosis.

INTRODUCTION: Systemic immunoglobulin light chain amyloidosis is characterized by the extracellular deposition of misfolded light chains, leading to progressive dysfunction of multiple organs. Diagnosis remains a significant clinical challenge and is frequently delayed due to the presence of nonspecific symptoms, coupled with limited access to specialized diagnostic tools and expertise. Currently, no established national recommendations for the diagnosis and management of this condition exist in Brazil. METHODS: These expert recommendations were developed following a structured advisory meeti

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… HCPs involved in diagnosis include, but are not limited to, primary care providers, medical internists, cardiologists, nephrologists, neurologists, gastroenterologists and hematologists [ 34 ]. … Healthcare specialists visited by patients were most often general practitioners (65%), nephrologists (52%), and cardiologists (34%) [ 25 ]. The median time from symptoms onset to diagnosis was 9.0 months with 90% of patients having at least two organs involved at the time of diagnosis [ 25 ]. …

Identifying Hemostatic Thresholds in Cancer Patients Undergoing Coronary Angiography Based on Platelet Count and Thromboelastography.

Objectives: To evaluate the role of platelet count and thromboelastogram (TEG) in the treatment of thrombocytopenic cancer patients with suspected coronary artery disease (CAD). Background: Cancer patients with CAD and thrombocytopenia are often treated non-invasively (i.e., without coronary angiography when clinically indicated) due to perceived high risk of bleeding. We sought to evaluate coagulability based on TEG and determine if platelet count and TEG could predict bleeding risk/mortality among cancer patients undergoing coronary angiography (CA). Methods: Baseline demographics, platelet

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… Cardiologists are increasingly involved in the care of cancer patients, with the intention of improving their overall survival (OS) ( 3 ) and quality of life—this is reflected by the increased number of cardiac interventions now being performed among cancer patients ( 4 ). … Thus, bleeding risk should not prevent interventional cardiologists from performing CA in cancer patients when clinically indicated. …

[Effectiveness and safety of the surgical closure of permeable arteriosus conduct by the general pediatric surgeon: clinical trial].

ANTECEDENTES: El conducto arterioso permeable (CAP) es un defecto cardiaco congénito y se considera un problema de salud pública. Se presenta en un alto porcentaje de recién nacidos y en algunos mayores de 1 mes. El cierre farmacológico es el tratamiento inicial preferido, ya que ha tenido excelentes resultados; sin embargo, en aquellos casos en los que no es posible, está indicado el cierre quirúrgico. OBJETIVO: Evaluar la eficacia y la seguridad del cierre quirúrgico del CAP por cirujanos pediatras sin especialidad en cirugía cardiovascular. MÉTODO: Ensayo clínico realizado en pacientes de

Management of prehospital thrombolytic therapy in ST-segment elevation acute coronary syndrome (<12 hours).

UNLABELLED: Acute myocardial infarction (AMI) is the prototype of a real emergency, and both efficacy and speed are necessary for effective management. The advent of thrombolysis therapy has transformed the care of these patients. In fact, the most frequent complication of AMI is sudden death which still occurs within the first hour after symptom onset. Thrombolytic therapy has been shown to reduce early and long term mortality about 20%. The mortality gain is dependent on the delay time of early reperfusion. A large number of studies have shown that this relationship is best described as expo

Genetics, cardiac phenotype and cardiovascular outcomes in Fabry disease patients in Finland.

AIMS: To investigate the genetics, cardiac phenotype and cardiovascular outcomes of Finnish Fabry patients. METHODS AND RESULTS: Among the 109 patients with Fabry disease (FD) diagnosed in Finland by 2018, 97 (89%; 32 males and 65 females, mean ages 42 and 52 years) were followed for a mean of 12 years. Data on genetics, phenotypes, cardiac imaging and cardiovascular outcomes were collected from the Fabry Registry and medical records. The 26 families with FD harboured 22 different hemi-/heterozygous GLA variants, most commonly p.R227X, p.A143T or p.P409A. The Fabry phenotype in males was clas

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… Data sources The data for this study were collected from both the Fabry Registry and the patients' hospital medical records by cardiologists with FD expertise until 17 October 2018. … Anderson‐Fabry disease management: role of the cardiologist. Eur Heart J 2024;45:1395‐1409. doi: 10.1093/eurheartj/ehae148 11. Adalsteinsdottir B, Palsson R, Desnick RJ, Gardarsdottir M, Teekakirikul P, Maron M, et al . …

Summary of the Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation.

The 2020 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation is intended to assist health care professionals worldwide who evaluate and manage potential candidates for deceased or living donor kidney transplantation. This guideline addresses general candidacy issues such as access to transplantation, patient demographic and health status factors, immunological and psychosocial assessment. The roles of various risk factors and comorbid conditions governing an individual's suitability for transpla

The Crossroads of Geriatric Cardiology and Cardio-Oncology.

Cancer and cardiovascular disease (CVD) are two major causes of mortality in older adults. With improved survival and outcomes from cancer and CVD, the role of the geriatrician is evolving. Geriatricians provide key skills to facilitate patient-centered and value-based care in the growing older population of cancer patients (and survivors). Cancer treatment in older adults is particularly injurious with respect to complications stemming from cancer therapy and as well as to CVD related to cancer therapy in the context of physiologic aging. To best meet their natural potential as caregiving lea

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… Cardiologists and oncologists may be less familiar with and often have limited to no training in routinely performing geriatric assessments and systematically evaluating for frailty. … At very few academic institutions with Centers of Excellence, there may be cardiologists or oncologists who specialize in geriatric cardiology, geriatric oncology, or cardio-oncology. …